Balakrishnan Pulapre, Namboodhiry Sreenath K
Department of Economics, Ashoka University, Sonipat, Haryana 131028 India.
Economics Area, Indian Institute of Management Kozhikode, Kunnamangalam, Kerala 673570 India.
Indian Econ Rev. 2021;56(1):233-254. doi: 10.1007/s41775-021-00116-7. Epub 2021 Jul 4.
Mortality due to COVID-19 has varied across the states of India. We exploit this history to investigate the possible role of health policy in the outcome. Using three different measures of the death rate, we find to a varying degree, evidence that the level of public expenditure on health has made a difference to the state-wise mortality rate. Based on this, we proceeded to analyse the expenditure pattern in the states. The average level of expenditure on health is found to be low both of itself and in relation to spending by governments in South and Southeast Asia. In much of the territory of India spending on the police exceeds that of spending on health. Furthermore, richer states spend relatively less on it, implying that spending on health is a matter of choice for states rather than dictated by financial constraints. Two conclusions follow. First, some of the mortality from COVID-19 is policy induced, and therefore was avoidable. Second, though the evidence is drawn from the experience with COVID-19, we may assume that assuring health security to the Indian population would require a radical restructuring of the spending priorities of the states.
印度各邦因新冠疫情导致的死亡率各不相同。我们利用这段历史来研究卫生政策在这一结果中可能发挥的作用。通过使用三种不同的死亡率衡量指标，我们在不同程度上发现，有证据表明卫生方面的公共支出水平对各邦的死亡率产生了影响。基于此，我们进而分析了各邦的支出模式。结果发现，卫生支出的平均水平本身较低，与南亚和东南亚各国政府的支出相比也较低。在印度大部分地区，警察方面的支出超过了卫生方面的支出。此外，较富裕的邦在卫生方面的支出相对较少，这意味着卫生支出是各邦的选择问题，而非受财政限制所迫。由此得出两个结论。第一，新冠疫情导致的部分死亡是政策引发的，因此是可以避免的。第二，尽管证据来自新冠疫情的经验，但我们可以假定，要确保印度民众的卫生安全，各邦需要彻底调整支出优先次序。
